IVD sector – Beacon of hope for Healthy India

IVD Industry and for that matter healthcare sector has assumed pole position in the post-Covid era. Covid pandemic exposed our vulnerabilities to various new viruses and other micro-organisms. While the incidence of non-communicable diseases is increasing, yet there is no denying the fact that communicable diseases are not going anywhere. We have to be on our toes and work collaboratively to ward off such diseases that have the propensity to threaten the mere existence of humankind. History teaches us a lot and if we take a leaf out of the Covid-19 pandemic chapter, it has taught us the importance of collaborative efforts and the fortitude with which the entire world came together to fight with the monstrous virus. Indian leadership, in particular, showed the path to the world by successfully managing the pandemic, creating the capacity in no time to carry out a couple of million Covid tests per day, making the vaccines available to not just its 1.4 billion citizens but also to many other countries. We showcased our ability to lay the process to launch the world’s largest immunization program and using CO-WIN App, administered 2 billion vaccines in just 18 months. Further, we tracked the immunization and the people very professionally by documenting the data with ICMR, IDSP, and local authorities.

Post Covid, people have started investing in health and many of them now understand the relevance of diagnostics, which was earlier taken as merely a perfunctory function. This newly found discernment around diagnostics will help in early diagnosis resulting into timely treatment, which would also minimize loss of productivity.

The diagnostics industry is at the cusp of witnessing significant growth. All the macro-economic drivers, such as increasing paying proclivity of the masses, thanks to the ever expanding middle class, aging population, increasing sensitivity around health insurance, etc., would provide the much needed tail winds to take IVD sector to the next level. The tests-to-accession (sample) ratio is abysmal in India (2:1) vis-a-vis various developed as well as some emerging economies (over 10:1), which shows that we undertake fewer tests at one go, which may potentially delay the start of treatment. By educating the people to get a comprehensive diagnosis would help immensely in dispensing early treatment. The collateral benefit would be that it will work as a growth catalyst for the industry.

The IVD work is slated to get a major fillip in the times to come, thanks to technological advancements and use of generative AI and ML. Further, the usage of IOT devices can augment diagnosis/treatment, using innovative means such as monitoring vitals of individuals remotely. Another area, which is getting good traction is the POCT, which is a potent tool to screen the people on various ailments, especially in the rural areas that are devoid of doctors and skilled workforce. Apart from the convenience it brings to patients, technology has the propensity to save costs and also bridge the urban-rural divide in terms of making superior quality healthcare or the diagnostics services accessible to the people living in Tier-III and Tier-IV towns or in the rural areas.

Another factor, which would significantly help the IVD industry growth, is the earnest efforts by the government to increase the spend on healthcare from a measly 1.2 percent of GDP in the year 2015 to 2.5 percent by 2025. The government spend, as a percentage of GDP, stood at 1.8 percent at the end of the year 2023. This is going to be augmented by increased investment by the private sector and the technological advancements that would result into bringing the costs down. It is also opined that timely diagnosis enables early treatment, which not only improves productivity but also saves huge amounts to the exchequer. After all the cost of diagnosis is only a fraction of the cost of treatment.

It may sound a bit clichéd but the fact of the matter is that for realizing the dream to provide universal health coverage, we need to make superior-quality diagnostics services accessible and affordable. The key to keeping the population healthy and productive is to make superior-quality diagnostics accessible, and to achieve this, we will need to differentiate between the players who are accredited, having qualified doctors (MD-pathologists/microbiologists/biochemists) and using automated platforms vis-a-vis those players who are neither following quality protocols (non-accredited labs), do not have qualified doctors/scientific staff nor use automated platforms, which are highly susceptible to providing erroneous results. It is pertinent to mention that in India there are about 300,000 labs, out of which barely 20 percent are using automated platforms/machines; less than 1 percent of these labs are accredited and there are less than 30,000 qualified MD-pathologists/microbiologists/biochemists who should be running these labs.

We will have to bring in some minimal and meaningful regulations to create a moat around those service providers who stand for quality lest they should succumb to the pricing pressure and either fall prey to cutting corners or shut shops. Further, to make healthcare/diagnostics affordable at the hands of the end customer/patient, the GST on the inputs has to be rationalized. Today, the industry pays GST on the inputs but cannot set it off against the output as it is prohibited to charge GST from the customers. Similarly, there is also a need to look into the customs duty structure. Access of healthcare and superior-quality diagnostics services will get a shot in the arm if all the approvals are given from a single window. Today, not only one is required to seek approvals from each state authority but within the same state, one has to seek approvals from the authorities at the district/ward level.

In order to redeem the commitment of realizing universal health coverage for the people, it is imperative that the government and the private sector work closely. The trust deficit has to go. A substantial part of healthcare is dispensed by the private sector and, therefore, a continuing meaningful dialogue between them is a no brainer. It is about time, we have a clear focus on preventive health/wellness and also strive to make healthcare/diagnostics outcome driven, where the measure of success is defined by patient satisfaction. This would ensure people remain productive and bring huge savings to the exchequer.